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. 2011 Oct;119(10):1415-20.
doi: 10.1289/ehp.1003206. Epub 2011 Jun 27.

Peat bog wildfire smoke exposure in rural North Carolina is associated with cardiopulmonary emergency department visits assessed through syndromic surveillance

Ana G Rappold  1 , Susan L Stone, Wayne E Cascio, Lucas M Neas, Vasu J Kilaru, Martha Sue Carraway, James J Szykman, Amy Ising, William E Cleve, John T Meredith, Heather Vaughan-Batten, Lana Deyneka, Robert B Devlin
Affiliations

Peat bog wildfire smoke exposure in rural North Carolina is associated with cardiopulmonary emergency department visits assessed through syndromic surveillance

Ana G Rappold et al. Environ Health Perspect. 2011 Oct.

Abstract

Background: In June 2008, burning peat deposits produced haze and air pollution far in excess of National Ambient Air Quality Standards, encroaching on rural communities of eastern North Carolina. Although the association of mortality and morbidity with exposure to urban air pollution is well established, the health effects associated with exposure to wildfire emissions are less well understood.

Objective: We investigated the effects of exposure on cardiorespiratory outcomes in the population affected by the fire.

Methods: We performed a population-based study using emergency department (ED) visits reported through the syndromic surveillance program NC DETECT (North Carolina Disease Event Tracking and Epidemiologic Collection Tool). We used aerosol optical depth measured by a satellite to determine a high-exposure window and distinguish counties most impacted by the dense smoke plume from surrounding referent counties. Poisson log-linear regression with a 5-day distributed lag was used to estimate changes in the cumulative relative risk (RR).

Results: In the exposed counties, significant increases in cumulative RR for asthma [1.65 (95% confidence interval, 1.25-2.1)], chronic obstructive pulmonary disease [1.73 (1.06-2.83)], and pneumonia and acute bronchitis [1.59 (1.07-2.34)] were observed. ED visits associated with cardiopulmonary symptoms [1.23 (1.06-1.43)] and heart failure [1.37 (1.01-1.85)] were also significantly increased.

Conclusions: Satellite data and syndromic surveillance were combined to assess the health impacts of wildfire smoke in rural counties with sparse air-quality monitoring. This is the first study to demonstrate both respiratory and cardiac effects after brief exposure to peat wildfire smoke.

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Conflict of interest statement

The research described in this article has been reviewed by the National Health and Environmental Effects Research Laboratory, U.S. EPA, and approved for publication. Approval does not signify that the contents necessarily reflect the views and the policies of the agency, nor does mention of trade names or commercial products constitute endorsement or recommendation for use. The N.C. Public Health Data Group and NC DETECT (North Carolina Disease Event Tracking and Epidemiologic Collection Tool) are not responsible for the scientific validity or accuracy of methodology, results, statistical analyses, or conclusions presented.

The authors declare they have no actual or potential competing financial interests.

Figures

Figure 1
Figure 1
Aerial maps showing counties impacted by the Evans Road Fire at the Pocosin Lakes National Wildlife Refuge on 10, 11, and 12 June 2008 (A, B, and C, respectively) as measured by satellite AOD images. (D) Assignment of counties as exposed or referent.
Figure 2
Figure 2
Daily counts of asthma-related ED visits in the exposed counties. Arrows represent the 3 days of high exposure (red) and the subsequent 5 lag days (blue).
Figure 3
Figure 3
Percent change in cRR and 95% CIs by discharge diagnosis category for exposed and referent counties in North Carolina during the 3‑day period of high exposure compared with the entire 6‑week study period. The vertical gray line indicates the null hypothesis of no change in cRR.
Figure 4
Figure 4
Percent change in cRR and 95% CIs by discharge diagnosis category for exposed and referent counties in North Carolina during the 3‑day period of high exposure compared with the entire 6‑week study period (A) by sex and (B) by age group. The 95% CI for URIs extending out of the figure reaches 1,816% in excess risk (cRR = 19.16) [see Supplemental Material, Table 4 (http://dx.doi.org/10.1289/ehp.1003206)].
See this image and copyright information in PMC

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